Free online chlamydia and gonorrhoea urine test request in Queensland, Australia: convenience of home sample collection versus pathology collection centre attendance for faster results

Background A free online chlamydia and gonorrhoea urine testing service (Webtest) is available for people living in Queensland, Australia. There are two options to provide a urine sample: at a pathology collection centre or by using a home mailing kit. The study aimed to trial these two testing options designed for young people and describe which is the preferred testing choice.

METHODS

Data for online requests made from 3 August 2017 to 31 December 2019 provides information for age, gender, location of clients, results received, treatment and partner notification reported by people with positive results.

RESULTS

For 29 months, there were 4642 Webtest requests and 2906 valid results received. For young people (16-29 years), chlamydia positivity was 8.2% (172/2105; 95% CI, 7.1-9.4) versus 3.2% (26/801; 95% CI, 2.2-4.7) for people aged ≥30 years, and 6.8% (198/2906; 95% CI, 6.0-7.8) for all ages. Home mailing kits were the most popular testing choice, with 68.0% (1977/2906) of results received from urine submitted by post and 32.0% (929/2906) via pathology collection centre.

CONCLUSIONS

The free online test request service engaged young people at risk of sexually transmissible infections and found home sample collection was most popular.

Sexually transmissible infections, partner notification and intimate relationships: a qualitative study exploring the perspectives of general practitioners and people with a recent chlamydia infection

Background Individuals diagnosed with a chlamydia infection are advised to notify their sexual partners from the previous 6 months so that they too can get tested and treated as appropriate. Partner notification is an essential component of chlamydia management, helping to prevent ongoing transmission and repeat infection in the index case. However, partner notification can be challenging, particularly in circumstances where a relationship has ended or transmission has occurred beyond the primary relationship.

METHODS

In this study we use data from 43 semistructured interviews with general practitioners (GPs) and people with a recent diagnosis of chlamydia. The interviews examined experiences of chlamydia case management in the general practice context. Here, we focus specifically on the effect of a chlamydia infection on intimate relationships in the context of the consultation and beyond.?

RESULTS

A chlamydia infection can have significant consequences for intimate relationships. Although GPs reported speaking to their patients about the importance of partner notification and participants with a recent chlamydia infection reported notifying their sexual partners, both would appreciate further support to engage in these conversations.

CONCLUSIONS

Conversations with patients should go beyond simply informing them of the need to notify their sexual partners from the previous 6 months, and should provide information about why partner notification is important and discuss strategies for informing partners, particularly for those in ongoing relationships. Ensuring GPs have the training and support to engage in these conversations with confidence is vital.

Patient-delivered partner therapy for chlamydia in Australia: can it become part of routine care?

Background Patient-delivered partner therapy (PDPT) is a method for an index patient to give treatment for genital chlamydia to their sexual partner(s) directly. In Australia, PDPT is considered suitable for heterosexual partners of men and women, but is not uniformly endorsed. We explored the policy environment for PDPT in Australia and considered how PDPT might become a routine option.

METHODS

Structured interviews were conducted with 10 key informants (KIs) representing six of eight Australian jurisdictions and documents relevant to PDPT were appraised. Interview transcripts and documents were analysed together, drawing on KIs' understanding of their jurisdiction to explore our research topics, namely the current context for PDPT, challenges, and actions needed for PDPT to become routine.

RESULTS

PDPT was allowable in three jurisdictions (Victoria, New South Wales, Northern Territory) where State governments have formally supported PDPT. In three jurisdictions (Western Australia, Australian Capital Territory, Tasmania), KIs viewed PDPT as potentially allowable under relevant prescribing regulations; however, no guidance was available. Concern about antimicrobial stewardship precluded PDPT inclusion in the South Australian strategy. For Queensland, KIs viewed PDPT as not allowable under current prescribing regulations and, although a Medicine and Poisons Act was passed in 2019, it is unclear if PDPT will be possible under new regulations. Clarifying the doctor-partner treating relationship and clinical guidance within a care standard were viewed as crucial for PDPT uptake, irrespective of regulatory contexts.

CONCLUSION

Endorsement and guidance are essential so doctors can confidently and routinely offer PDPT in respect to professional standards and regulatory requirements.

Free online chlamydia and gonorrhoea urine test request in Queensland: sexually transmissible infections testing can be hard for young people even if the process is easy

Online options to request sexually transmissible infections testing are increasingly popular and a free online chlamydia and gonorrhoea urine testing service is available for people living in Queensland, Australia. Data from 3 August 2017 to 31 August 2019 provide information for 1316 reminder calls to young people (aged 16-29 years) to encourage sample submission. The reminder calls generated few additional samples for testing, suggesting young people may have changed their mind about using the service, sought testing elsewhere or were reluctant to talk further about their original decision to request a test online.

The increasing cost of the basic foods required to promote health in Queensland

OBJECTIVE

To assess changes in the cost and availability of a standard basket of healthy food items (the Healthy Food Access Basket [HFAB]) in Queensland over time.

DESIGN AND PARTICIPANTS

A series of four cross-sectional surveys (in 1998, 2000, 2001 and 2004) describing the cost and availability of foods in the HFAB over time. In the latest survey, 97 Queensland food stores across the five Australian Bureau of Statistics remoteness categories were compared.

MAIN OUTCOME MEASURES

Cost comparisons for HFAB items by remoteness category for the 97 stores surveyed in 2004; changes in cost and availability of foods in the 81 stores surveyed since 2000; comparisons of food prices in the 56 stores surveyed in 1998, 2000, 2001 and 2004.

RESULTS

In 2004, the Queensland mean cost of the HFAB was $395.28 a fortnight. The cost of the HFAB was 29.6% ($113.89) higher in "very remote" areas than in "major cities" (P < 0.001). Between 2001 and 2004, the Queensland mean cost of the HFAB increased by 14.0% ($48.45), while in very remote areas the cost increased by 18.0% ($76.93) (P < 0.001). Since 2000, the annualised per cent increase in cost of the HFAB has been higher than the increase in Consumer Price Index for food in Brisbane. The cost of healthy foods has risen more than the cost of some less nutritious foods, so that the latter are now relatively more affordable.

CONCLUSIONS

Consumers, particularly those in very remote locations, need to pay substantially more for basic healthy foods than they did a few years ago. Higher prices are likely to be a barrier to good health among people of low socioeconomic status and other vulnerable groups. Interventions to make basic healthy food affordable and accessible to all would help reduce the high burden of chronic disease.